- Travelers Insurance Company (New York, NY)
- …will collaborate and communicate with many business functions and partners, such as Claim , Actuarial Pricing, Claim Analytics, and Finance. **What Will You Do?** ... as assigned. What Will Our Ideal Candidate Have? + 3 or more Actuarial exams preferred . + College degree in STEM related field. + Strong PC skills (MS Office), basic… more
- CVS Health (Albany, NY)
- …supports the international network, medical cost management, and overall claim /customer service experience. The candidate will provide concierge-level service to ... Network manager in ensuring service level adherence (GOP TAT, eligibility processing, claim TAT, reconciliation TAT, fee invoicing etc) + Ensure TPA networks are… more
- Travelers Insurance Company (St. Paul, MN)
- …the individual will work closely with diverse business functions and partners, including Claim , Actuarial Pricing, Claim Analytics, and Finance. **What Will You ... Have?** + College degree in STEM related field. + Associate Actuarial Credential preferred . + Strong PC skills (MS Office) and programming skills (eg. SQL, SAS).… more
- Henry Ford Health System (MI)
- …high risk of denial or with high charges are verified for accuracy prior to claim submission + Managing authorization related denied claims to ensure the highest ... + Associates degree in Business Administration, Accounting, or related field preferred . + Two years of experience with healthcare accounts receivable required.… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary + Works hospital claims to assure timely billing and appropriate reimbursement from Non-Governmental Insurance Companies. Primary Position ... tools, software and reports provided. + Perform all activities for billing, claim adjustment, account follow-up processes. + Complete payment review, working Compass… more
- International (San Antonio, TX)
- …focusing on delivering high-quality solutions* Relies on evidence to back claims and maintains high standards* Thinks independently, makes clear decisions, and ... data analysis and collection, etc. (required) + PINpoint MES ( preferred ) + Cloud computing solutions ( preferred ) +...15,000-person-strong company we are today, few companies can lay claim to a history like International. Based in Lisle,… more
- St. Luke's University Health Network (Allentown, PA)
- …codes to individual patient medical records for data retrieval, analysis and claims processing. Codes and abstracts all pertinent medical information according to ... Assist the coding manager with hospital coding workflow, monitoring account and claim edit work queues and re-assigning coding professionals as needed, including… more
- Independent Health (Buffalo, NY)
- …and resolve inquiries; provide benefit clarification and eligibility; communicate claim and reimbursement information, facilitate proper utilization of policies and ... and procedures. **Qualifications** + High School or GED required; Associate degree preferred + Six (6) months experience working for a health insurance company,… more
- CVS Health (Bassett, VA)
- …including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. ... cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and… more
- AmeriHealth Caritas (Manchester, NH)
- …processes, ensuring compliance with pricing guidelines, contract standards, and claim payment methodologies. + Drive implementation of electronic strategies to ... improve claims submission, auto-adjudication, and operational efficiency. + Ensure departmental...administration or healthcare management, and equivalent business experience is preferred . + A minimum of 3 years of experience… more